Compartment Syndrome (Tabor) Flashcards Preview

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Flashcards in Compartment Syndrome (Tabor) Deck (25)
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1

Define compartment syndrome

life threatening and limb-threatening condition that results when perfusion pressure falls below tissue pressure in a close anatomical space

2

What are general causes of compartment syndrome

constriction (casts/tight ski boots/strangulation in neonates...)

internal increase in pressure (fracture, trauma, drugs, Ruptured Baker's cyst...)

3

What is the general pathogenesis of compartment syndrome?

Muscles and peripheral nerves intolerant to hypoxia. Hypoxia causes release of vasoactive/inflammatory substances (ex. serotonin)

4

Where does compartment syndrome occur?

anywhere in the body where skeletal muscle is surrounded by fascia and bone

5

Where is the most common location for compartment syndrome?

Anterior compartment of lower leg (80%)

6

A 28 year old male patient presents with a deep, throbbing, burning pain. He states that he feels pain at rest and with activity, as well as with stretching of the muscles. What could he have?

ACUTE compartment syndrome

give away: pain at REST and w/ activity

7

Decreases sensation of light tough and within the 1st web space of the feet can describe injury of what nerve? Which compartment is this related to?

Deep Peroneal N. in the Anterior lower leg compartment

8

If a patient presents with a tibia or fibula fracture, what nerve could this effect, and in which compartment would exhibit compartment syndrome?

Tibial Nerve in the Deep Posterior lower leg compartment

9

What are the 5 P's of diagnosing compartment syndrome?

Pallor
Pain
Pulselessness
Paresthesias
Paralysis

10

If a patient only show 3 of the 5 P's for compartment syndrome, could they still be diagnosed for having compartment syndrome?

Yes; Not all symptoms need to be present for diagnosis, but if you have all of them, you DEFINITELY have compartment syndrome

11

What is the gold standard for compartment syndrome diagnosis?

Compartment pressure testing

12

What is the definition of Chronic Extertional compartment syndrome (CECS)

- Overuse injury affecting young endurance athletes
- Results from increased pressure in osteofascial planes
- Predominantly in LOWER leg
- Lack of compliance of fascia increases compartment pressure due to expanding muscles

13

A 28 y/o runner wants to stop running and decides to fake having a lower extremity CECS, what symptoms should he fake?

-Gradual increase with pain several minutes after starting to run.
- Pain goes away after cessation of activity
- weakness or paresthesias

14

If you are thinking an 18 year old female runner has CECS, what diseases should you eliminate first?

- Medial tibial stress syndrome
- Stress reaction/fracture
- Deep vein thrombosis (DVT) ***
- Peripheral nerve entrapment
- Lumbar radiculopathy ***
- Tendinopathy ***

15

What is the gold standard to measure compartment pressure syndrome?

Measure compartment pressure directly.

16

How is CECS diagnosed?

- Patient performs exercise which reproduces symptoms
- Check each compartment 3x

17

At resting, what compartment pressure is necessary to diagnose CECS?

15mmHg

18

1 minute post-exercise, what is the minimum compartment pressure necessary to diagnose CECS?

30mmHg

19

5 minute post-exercise, what is the minimum compartment pressure necessary to diagnose CECS?

20mmHg

20

What are the two general treatments categories for CECS?

Conservative and surgical

21

What is the most common surgical treatment for CECS?

2-incision approach

22

What are the contraindications of fasciotomy for CECS?

after 4 days of symptoms

23

What is considered Conservative Treatment for CECS?

physical therapy
Ice
OMT
Modification of exercise
Shoe modification

24

What is normal compartment pressure?

0-4 mmHg

25

What is the most common handheld electronic device for measuring CECS?

Stic Catheter by Stryker